Arrhythmias and their pathophysiological correlations with SARS-COV 2 infection

Abstract

Introduction: The pandemic caused by SARS-CoV 2 is considered one of the most critical public health events in the last decades. That said, knowledge of the manifestations of the disease is relevant. Of the changes already described in the literature, cardiac arrhythmias have been receiving increasing prominence. Objective: To discuss the pathogenesis of arrhythmias in the context of the Coronavirus infection and, thus, elucidate the mechanisms of aggression of this virus against cardiac tissue. Methods: This is a cross-sectional and integrative review. Research was carried out in databases such as SciELO, PubMed and Google Scholar. Articles in English, Portuguese and Italian published between 2020 and 2023 were selected. Result: Cardiac arrhythmia because of infection is related to the hyperinflammatory state developed in response to the virus or by direct invasion of structures that have the ACE-2 receptor. Ischemic lesions occur in the sinoatrial node and in the myocardium because of the formation of vascular thrombi caused by inflammation, which impair the rhythm and contraction of this organ, taking it from its sinus rhythm. Regarding direct invasion, the sarcolemma of the cardiomyocytes is ruptured, thus impairing the adequate propagation of the electrical impulse throughout the cardiac tissue and compromises its normal functioning. Conclusion: There is a close relationship between COVID-19 infection and the occurrence of arrhythmias, as well as an increase in morbidity and mortality in infected patients.